Change of self-schemas following mindfulness-based compassionate living for recurrent depression: A qualitative study

Objectives: Compassion-based interventions, like Mindfulness-Based Compassionate Living (MBCL), are increasingly recognized as treatments for depression. This study explores the impact of MBCL on self-schemas. Methods: As part of an RCT on MBCL for depression, self-description interviews of approximately 3 min in duration were conducted with 24 patients before and after MBCL and were analyzed using mixed methods. Qualitative analysis used both a deductive approach (based on the Five Factor Model) to identify themes and an inductive approach to explore subthemes within those themes. Additionally, Linguistic Inquiry and Word Count (LIWC) software analyzed words in psychologically relevant categories. Results: Deductive analysis revealed a shift from neuroticism to emotional stability and a decrease in agreeableness. Inductive analysis highlighted a transition from self-criticism to self-compassion, and a shift from prioritizing others ‘needs at the expense of self-care to a more balanced approach. LIWC analysis indicated that post-MBCL, patients used more words overall (W = 2.8; p = 0.006), but fewer positive emotion words (W = -3.1; p = 0.002) and fewer words related to cognitive processes (W = -2.6; p = 0.009). Conclusions: MBCL appears to be associated with changes in self-schemas and interpersonal dynamics, providing insights for future (linguistic) studies on the mechanisms of MBCL. These findings should be carefully interpreted considering the methodological limitations of the current investigation, including differing pre- and post-interview prompts and a sample of treatment completers.